Online technologies have facilitated the development of Virtual Communities of Practice (virtual CoPs) to support health professionals collaborate online to share knowledge, improve performance and support the spread ...Online technologies have facilitated the development of Virtual Communities of Practice (virtual CoPs) to support health professionals collaborate online to share knowledge, improve performance and support the spread of innovation and best practices. Research, however,shows that many virtual CoPs do not achieve their expected potential because online interaction among healthcare professionals is generally low. Focusing on health visitors, who are UK qualified midwives or nurses who have undertaken additional qualifications as specialist public health workers in the community, the paper examines the factors that influence online interaction among health visitors collaborating to share knowledge and experience in a virtual CoP. The paper makes suggestions for how to improve online interaction among health professionals in virtual CoPs by increasing the size of membership in order to take advantage of both posting and viewing contributions, facilitating moderation to improve networking among geographically dispersed members groups and im-proving the topic relevance in order to stimulate contributions.展开更多
In this article,Deng and Song showed compelling evidence on the connection between heart rate variability(HRV)alterations and cancer in 127 cancer patients compared with healthy reference individuals,highlighting auto...In this article,Deng and Song showed compelling evidence on the connection between heart rate variability(HRV)alterations and cancer in 127 cancer patients compared with healthy reference individuals,highlighting autonomic nervous system dysfunction as a significant physiological manifestation in cancer patients.We discussed that the reduced HRV may be associated with cancer treatments,e.g.,operation,chemotherapy and pain control and psychological response such as depression and anxiety related to the affected cancer.A management such as medicine to mood disturbances related to cancer has been shown a benefit to improve HRV in cancer patients.展开更多
Background Health promotion(HP)interventions delivered through sports clubs have demonstrated promising outcomes among men,but less is known about which aspects of the interventions work,for whom,and under what circum...Background Health promotion(HP)interventions delivered through sports clubs have demonstrated promising outcomes among men,but less is known about which aspects of the interventions work,for whom,and under what circumstances.This rapid realist review aimed to understand the contexts,mechanisms,and outcomes of HP interventions for men delivered through sports clubs.Methods A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE,Embase,and SPORTDiscus databases.Included studies:(a)were delivered by or in collaboration with sports clubs,(b)targeted men aged 18+years,and(c)reported 1 or more HP outcomes.A grey literature search was also performed.Studies were included in a realist synthesis based on richness and rigor.Hereafter,context-mechanism-outcome(CMO)configurations were developed.Results We identified and screened 3358 studies,finally including 59 studies describing 22 interventions.Most HP interventions were delivered in high income countries,included Caucasian men aged 35-65 years with overweight/obesity,and used professional sports clubs(mostly football)for recruitment and facilities.Quantitative HP outcomes were reported across 19 interventions.Of these 19 interventions,the majority reported on weight(n=18),physical activity(n=12),mental health(n=10),and diet(n=9).We identified 13 CMOs related to how HP interventions affected men's recruitment,engagement,and health behavior maintenance.Conclusion Our findings show that using sports clubs for HP interventions is effective for engaging men.Recruitment was facilitated by leveraging sports clubs’identity,addressing masculinity-related barriers,improving accessibility,and building trust.Engagement was enhanced through shared identity experiences,safe spaces,inclusive competition,and self-efficacy.However,there's limited evidence on behavior maintenance post-intervention,though involving community stakeholders seemed vital.In general,considerations should be made to avoid perpetuating traditional masculine norms,which may exclude some men and reinforce unhealthy behaviors.These findings can guide intervention development,emphasizing the need to harness men's perspectives in the process.展开更多
Periodontitis is a common oral disease characterized by progressive alveolar bone resorption and inflammation of the periodontal tissues.Dimethyl fumarate(DMF)has been used in the treatment of various immune-inflammat...Periodontitis is a common oral disease characterized by progressive alveolar bone resorption and inflammation of the periodontal tissues.Dimethyl fumarate(DMF)has been used in the treatment of various immune-inflammatory diseases due to its excellent anti-inflammatory and antioxidant functions.Here,we investigated for the first time the therapeutic effect of DMF on periodontitis.In vivo studies showed that DMF significantly inhibited periodontal destruction,enhanced mitophagy,and decreased the M1/M2 macrophage ratio.In vitro studies showed that DMF inhibited macrophage polarization toward M1 macrophages and promoted polarization toward M2 macrophages,with improved mitochondrial function,inhibited oxidative stress,and increased mitophagy in RAW 264.7 cells.Furthermore,DMF increased intracellular mitochondrial Tu translation elongation factor(TUFM)levels to maintain mitochondrial homeostasis,promoted mitophagy,and modulated macrophage polarization,whereas TUFM knockdown decreased the protective effect of DMF.Finally,mechanistic studies showed that DMF increased intracellular TUFM levels by protecting TUFM from degradation via the ubiquitin-proteasomal degradation pathway.Our results demonstrate for the first time that DMF protects mitochondrial function and inhibits oxidative stress through TUFM-mediated mitophagy in macrophages,resulting in a shift in the balance of macrophage polarization,thereby attenuating periodontitis.Importantly,this study provides new insights into the prevention of periodontitis.展开更多
This study examines the difference of the center of gravity (CG) velocity during sit-to-stand (STS) movement between the elderly with and without fall experience. Fifteen elderly without fall experience (age: 75.7 ...This study examines the difference of the center of gravity (CG) velocity during sit-to-stand (STS) movement between the elderly with and without fall experience. Fifteen elderly without fall experience (age: 75.7 ± 4.8 yr), with one fall experience (age: 75.7 ± 5.0 yr), and two or more fall experiences (age: 75.7 ± 4.8 yr) participated in the measurement of 10m maximal walking speed, functional reach, one-legged standing duration with vision, maximal isometric knee extension, hip flexion, ankle extension and toe flexion muscle strengths, fall risk assessment and ADL questionnaire, and CG velocity during STS movement. No significant differences were found in muscle strength, walking and balance tests (F 0.078). The group with two or more fall experiences was significantly higher than the other groups in the fall risk assessment, and lower than the group without fall experience in ADL (F = 8.5 and 6.1, p = 0.001 and 0.005). Meanwhile, significant differences were found in the maximal and mean CG velocity during STS movement among all groups. The group without fall experience was the greatest, and the group with fall experience was less than half (F = 9.0 and 11.1, p = 0.001展开更多
In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights...In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights derived from current studies.Furthermore,we emphasize the critical need for a framework regarding robust risk evaluation in patients undergoing such treatments.This framework is essential for identifying those at increased risk of HBVr,enabling healthcare providers to implement proactive measures to prevent reactivation and ensure the safe administration of BTK inhibitor therapy.展开更多
Objective To determine whether smoking increases the risk for developing metabolic syndrome （MetS） in Chinese men.Methods A total of 693 men with no MetS at baseline were followed for 2.9‐5.5 years.Subjects were di...Objective To determine whether smoking increases the risk for developing metabolic syndrome （MetS） in Chinese men.Methods A total of 693 men with no MetS at baseline were followed for 2.9‐5.5 years.Subjects were divided into nonsmokers,ex‐smokers,and current smokers according to baseline smoking status.Results After adjusting for age,education level,alcohol intake,fasting plasma insulin,HOMA‐IR index,and BMI at baseline and weight change,current smokers were dose‐dependently associated with increased risk for developing new MetS compared with nonsmokers.The odds ratio （OR） was 2.131 （95% CI,1.264,3.592;P0.01） for the NCEPIII definition or 3.083 （95% CI,1.807,5.295;P0.01） for the JCDCG definition of MetS.Ex‐smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition.Compared with nonsmokers,current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL‐C.Conclusion Smoking is a risk factor for developing MetS in Chinese men after adjusting for age,education level,alcohol intake,fasting plasma insulin,HOMA‐IR,BMI,and weight change.This could be due to an increased incidence of dyslipidemia.Smoking cessation for 13 years decreased the risk for developing MetS defined by the JCDCG definition.展开更多
Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and ...Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.展开更多
AIM To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy(TGRY) and distal gastrectomy with the same Rouxen-Y(DGRY) reconstruction. The study was conducted using an integra...AIM To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy(TGRY) and distal gastrectomy with the same Rouxen-Y(DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale(PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working Party.METHODS The PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni-and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY(n = 393) or DGRY(n = 475) for stage I gastric cancer(52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy(TGRY/DGRY), interval after surgery, age, gender, surgical approach(laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life(QOL).RESULTS The patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables. CONCLUSION The results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.展开更多
The purpose of this study is to prepare a nursing protocol for preventing interruptions during clinical examinations and treatments performed in the early days of hospitalization for acute exacerbation of chronic hear...The purpose of this study is to prepare a nursing protocol for preventing interruptions during clinical examinations and treatments performed in the early days of hospitalization for acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the research, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 73 subjects (84.9%) considered effective for patients, in terms of prevention of interruptions during clinical examinations and treatments in the early days of hospitalization. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 84.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We consider that this nursing protocol will be useful especially for newly graduated/employed nurses as a procedure manual which can reduce their anxiety or stress caused by lack of knowledge or experiences.展开更多
AIM: To determine the efficacy of Mac-2 binding protein (Mac-2bp) for diagnosis of chronic pancreatitis.METHODS: Fifty-nine healthy volunteers (HV), 162 patients with chronic pancreatitis (CP), and 94 patients with pa...AIM: To determine the efficacy of Mac-2 binding protein (Mac-2bp) for diagnosis of chronic pancreatitis.METHODS: Fifty-nine healthy volunteers (HV), 162 patients with chronic pancreatitis (CP), and 94 patients with pancreatic ductal adenocarcinoma (PDAC) were enrolled in this study. We measured serum Mac-2bp using our developed enzyme-linked immunosorbent assay kit. Additional biochemical variables were measured using an automated analyzer (including aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, triglyceride, C-reactive protein, and amylase levels) or chemiluminescent enzyme immunoassay (carbohydrate antigen 19-9 and carcinoembryonic antigen). The ability of Mac-2bp to predict CP diagnosis accurately was assessed using receiver operating characteristic (ROC) analyses.RESULTS: Serum Mac-2bp levels were significantly increased in CP patients compared to HV (P < 0.0001) and PDAC patients (P < 0.0001). Area under the ROC curve values of Mac-2bp for the discrimination of CP from HV and PDAC were 0.727 and 0.784, respectively. Multivariate analyses demonstrated that serum Mac-2bp levels were independent determinants for CP diagnosis from HV and PDAC patients. Immunohistological staining showed that Mac-2bp was expressed faintly in the pancreas tissues of both CP and PDAC patients. Serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, and triglyceride levels were significantly higher in patients with CP or PDAC. Serum Mac-2bp levels were highly correlated with protein levels of alanine aminotransferase, γ-glutamyltransferase, and C-reactive protein, but not amylase, suggesting that the damaged liver produces Mac-2bp.CONCLUSION: Measurement of serum Mac-2bp may be a novel and useful biomarker for CP diagnosis as well as liver fibrosis in the general population.展开更多
OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49year...OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49years) women who were treated for breast cancer from January 2011 through June 2015 in a Taiwan Residents city participated in the study. Of 306 eligible study participants, interviews were completed in197(64%). Participants were asked about sociodemographic variables, disease and treatment characteristics, their desire for fertility, and their use of Western or Chinese Medicine.RESULTS: The proportions of women who planned to use Western or Chinese Medicine to help achieve pregnancy were 17.3% and 14.7%, respectively. The result of binary logistic regression showed that current employment and lack of children were factors predictive of the use of Western Medicine. Younger age and the use of Chinese Medicine before treatment were predictors of using Chinese Medicine. While the desire for fertility preservation was related to the use of Western Medicine,the desire for pregnancy was related to the use of Chinese Medicine.CONCLUSION: Various characteristics guided the women's decisions to use Western or Chinese Medicine. Health care providers should learn patients' preferences for fertility preservation and provide appropriate advice, referring them to safe providers of their desired method of fertility treatment.展开更多
We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 p...We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 patients, 21 patients in the newly-initiated group and 25 patients in the existing BOT group performed dose adjustment using 3-3-1 algorithm. HbA1c was significantly improved 4 weeks after the initiation from 8.5% ± 1.2% at baseline to 7.3% ± 0.7% at the final evaluation (p 0.01, vs. Baseline). The average daily insulin units increased throughout the study period from 10.1 ± 6.7 at baseline to 14.6 ± 8.9 units at the final evaluation. Weight didn’t significantly change throughout the study (p = 0.12). The incidents of hypoglycemia were 0.8/month during the insulin dose self-adjustment period and 0.4/month during the follow-up period. The 3-3-1 algorithm using insulin glargine provided a safe and simple dose adjustment and demonstrated its utility in patients who were newly introduced to insulin treatment as well as who were already on BOT.展开更多
The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with ...The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.展开更多
BACKGROUND The prognosis of hepatocellular carcinoma(HCC)patients remains poor despite advances in treatment modalities and diagnosis.It is important to identify useful markers for the early detection of HCC in patien...BACKGROUND The prognosis of hepatocellular carcinoma(HCC)patients remains poor despite advances in treatment modalities and diagnosis.It is important to identify useful markers for the early detection of HCC in patients.Preneoplastic antigen(PNA),originally reported in a rat carcinogenesis model,is increased in the tissues and serum of HCC patients.AIM To determine the diagnostic value of PNA for discriminating HCC and to characterize PNA-positive HCC.METHODS Patients with hepatitis C virus(HCV)-related hepatic disorders were prospectively enrolled in this study,which included patients with hepatitis,with cirrhosis,and with HCC.A novel enzyme-linked immunosorbent assay was developed to measure serum PNA concentrations in patients.RESULTS Serum PNA concentrations were measured in 89 controls and 141 patients with HCV infections(50 hepatitis,44 cirrhosis,and 47 HCC).Compared with control and non-HCC patients,PNA was increased in HCC.On receiver operating characteristic curve analysis,the sensitivity of PNA was similar to the HCC markers des-γ-carboxy-prothrombin(DCP)andα-fetoprotein(AFP),but the specificity of PNA was lower.There was no correlation between PNA and AFP and a significant but weak correlation between PNA and DCP in HCC patients.Importantly,the correlations with biochemical markers were completely different for PNA,AFP,and DCP;glutamyl transpeptidase was highly correlated with PNA,but not with AFP or DCP,and was significantly higher in PNA-high patients than in PNA-low patients with HCV-related HCC.CONCLUSION PNA may have the potential to diagnose a novel type of HCC in which glutamyl transpeptidase is positively expressed but AFP or DCP is weakly or negatively expressed.展开更多
BACKGROUND Ectopic adrenocorticotropic hormone(ACTH)-secreting neuroendocrine tumors are rare diseases.Patients with ACTH-secreting pancreatic neuroendocrine carcinomas have a poor prognosis.Infections and coagulopath...BACKGROUND Ectopic adrenocorticotropic hormone(ACTH)-secreting neuroendocrine tumors are rare diseases.Patients with ACTH-secreting pancreatic neuroendocrine carcinomas have a poor prognosis.Infections and coagulopathies have been reported as the cause of death.However,detailed clinical descriptions of the morbid complications of ACTH-secreting neuroendocrine carcinomas have not been reported.CASE SUMMARY A 78-year-old Japanese woman consulted a medical center due to systemic edema and epigastric discomfort.Laboratory analysis revealed hypercortisolemia with increased ACTH secretion without diurnal variation in serum cortisol level.An enhanced computed tomography(CT)scan revealed a 3-cm tumor in the pancreatic head.The cytological material from endoscopic ultrasound-guided fine-needle aspiration was compatible with ACTHsecreting pancreatic neuroendocrine carcinoma.The Ki-67 index was 40%.She was transferred to Mie University Hospital for surgical treatment.The patient was diagnosed with urinary tract infection,cytomegalovirus hepatitis,esophageal candidiasis,pulmonary infiltrates suspicious for Pneumocystis carinii pneumonia,peripheral deep vein thrombosis,pulmonary embolism,and disseminated intravascular coagulation.The multiple organ infections and thromboses responded well to antimicrobial and anticoagulant therapy.Radioisotope studies disclosed a pancreatic tumor and a metastatic lesion in the liver,whereas somatostatin receptor scintigraphy showed negative findings,suggesting the primary and metastatic tumors were poorly differentiated.A CT scan before admission showed no metastatic liver lesion,suggesting that the pancreatic tumor was rapidly progressing.Instead of surgery,antitumor chemotherapy was indicated.The patient was transferred to another hospital to initiate chemotherapy.However,she died four months later due to the rapidly progressive tumor.CONCLUSION ACTH-secreting pancreatic neuroendocrine neoplasm is a rare disease with a very poor prognosis.The clinical course and acute complications of the tumor remain unreported.Here we report the clinical course of a rapidly progressive case of ACTH-secreting pancreatic neuroendocrine tumor that developed infectious complications due to many types of pathogens in multiple organs,widespread thromboses,pulmonary embolism,and disseminated intravascular coagulation.展开更多
The healing of critical-sized bone defects(CSD)remains a challenge in orthopedic medicine.In recent years,scaffolds with sophisticated microstructures fabricated by the emerging three-dimensional(3D)printing technolog...The healing of critical-sized bone defects(CSD)remains a challenge in orthopedic medicine.In recent years,scaffolds with sophisticated microstructures fabricated by the emerging three-dimensional(3D)printing technology have lighted up the treatment of the CSD due to the elaborate microenvironments and support they may build.Here,we established a magnesium oxide-reinforced 3D-printed biocompos-ite scaffold to investigate the effect of magnesium-enriched 3D microenvironment on CSD repairing.The composite was prepared using a biodegradable polymer matrix,polycaprolactone(PCL),and the disper-sion phase,magnesium oxide(MgO).With the appropriate surface treatment by saline coupling agent,the MgO dispersed homogeneously in the polymer matrix,leading to enhanced mechanical performance and steady release of magnesium ion(Mg^(2+))for superior cytocompatibility,higher cell viability,advanced osteogenic differentiation,and cell mineralization capabilities in comparison with the pure PCL.The in-vivo femoral implantation and critical-sized cranial bone defect studies demonstrated the importance of the 3D magnesium microenvironment,as a scaffold that released appropriate Mg^(2+) exhibited remarkably increased bone volume,enhanced angiogenesis,and almost recovered CSD after 8-week implantation.Overall,this study suggests that the magnesium-enriched 3D scaffold is a potential candidate for the treatment of CSD in a cell-free therapeutic approach.展开更多
This study aimed at examining the differences in leg strength and activities of daily living (ADL) ability among groups with various knee problems. The subjects consisted of 328 elderly females who were classified int...This study aimed at examining the differences in leg strength and activities of daily living (ADL) ability among groups with various knee problems. The subjects consisted of 328 elderly females who were classified into three groups: those without knee pain or a knee disorder, those with knee pain, and those with a knee disorder. The subjects took a knee extension strength test and an ADL survey. Knee extension strength and ADL scores (total score and each domain score of the motions of locomotion, posture change, stability, and manipulation) were selected as the evaluation parameters. The knee extension strength, total ADL score and each domain score of the motions of locomotion, posture change, and stability ranged from low to high in the following order: the group with a knee disorder, the group with knee pain, and the group without pain or a knee disorder. Moreover, manipulation scores were significantly inferior in the group with a knee disorder compared with the other two groups. In conclusion, the female elderly with knee pain or a knee disorder have inferior knee extension strength and ADL with respect to the motions of locomotion, posture change and stability. In addition, with regard toknee extension strength with respect to theabove three motions, the elderly with a knee disorder have inferior scores when compared with the elderly who have only knee pain;thus, they find it difficult to perform activities involving the knee joints.展开更多
Gout is a common disease caused by the deposition of monosodium urate(MSU) crystals in patients with hyperuricemia, and characterized by very painful recurrent acute attacks of arthritis. The gold standard for diagnos...Gout is a common disease caused by the deposition of monosodium urate(MSU) crystals in patients with hyperuricemia, and characterized by very painful recurrent acute attacks of arthritis. The gold standard for diagnosing gout is the identification of MSU crystals in synovial fluid by polarization light microscopy. Arthritis attacks can be treated with anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs, colchicine, oral prednisone, or intra-articular or intramuscular glucocorticoids. To prevent gout uric acid lowering therapy with for example allopurinol can be prescribed. When gout is adequately treated, the prognosis is good. Unfortunately, the management of gout patients is often insufficient. Gout is associated with dietary factors, the use of diuretics, and several genetic factors. Comorbidities as hypertension, chronic kidney disease, cardiovascular diseases, the metabolic syndrome, diabetes, obesity, hyperlipidemia, and early menopause are associated with a higher prevalence of gout. Xanthine oxidase and chronic systemic inflammation seem to play an important role in the pathophysiology of the association between gout and cardiovascular diseases. To prevent cardiovascular diseases goutpatients must be early screened for cardiovascular risk factors.展开更多
文摘Online technologies have facilitated the development of Virtual Communities of Practice (virtual CoPs) to support health professionals collaborate online to share knowledge, improve performance and support the spread of innovation and best practices. Research, however,shows that many virtual CoPs do not achieve their expected potential because online interaction among healthcare professionals is generally low. Focusing on health visitors, who are UK qualified midwives or nurses who have undertaken additional qualifications as specialist public health workers in the community, the paper examines the factors that influence online interaction among health visitors collaborating to share knowledge and experience in a virtual CoP. The paper makes suggestions for how to improve online interaction among health professionals in virtual CoPs by increasing the size of membership in order to take advantage of both posting and viewing contributions, facilitating moderation to improve networking among geographically dispersed members groups and im-proving the topic relevance in order to stimulate contributions.
文摘In this article,Deng and Song showed compelling evidence on the connection between heart rate variability(HRV)alterations and cancer in 127 cancer patients compared with healthy reference individuals,highlighting autonomic nervous system dysfunction as a significant physiological manifestation in cancer patients.We discussed that the reduced HRV may be associated with cancer treatments,e.g.,operation,chemotherapy and pain control and psychological response such as depression and anxiety related to the affected cancer.A management such as medicine to mood disturbances related to cancer has been shown a benefit to improve HRV in cancer patients.
基金supported by the 5 Steno Diabetes Centers in Denmark,which are partly funded by the Novo Nordisk Foundation.
文摘Background Health promotion(HP)interventions delivered through sports clubs have demonstrated promising outcomes among men,but less is known about which aspects of the interventions work,for whom,and under what circumstances.This rapid realist review aimed to understand the contexts,mechanisms,and outcomes of HP interventions for men delivered through sports clubs.Methods A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE,Embase,and SPORTDiscus databases.Included studies:(a)were delivered by or in collaboration with sports clubs,(b)targeted men aged 18+years,and(c)reported 1 or more HP outcomes.A grey literature search was also performed.Studies were included in a realist synthesis based on richness and rigor.Hereafter,context-mechanism-outcome(CMO)configurations were developed.Results We identified and screened 3358 studies,finally including 59 studies describing 22 interventions.Most HP interventions were delivered in high income countries,included Caucasian men aged 35-65 years with overweight/obesity,and used professional sports clubs(mostly football)for recruitment and facilities.Quantitative HP outcomes were reported across 19 interventions.Of these 19 interventions,the majority reported on weight(n=18),physical activity(n=12),mental health(n=10),and diet(n=9).We identified 13 CMOs related to how HP interventions affected men's recruitment,engagement,and health behavior maintenance.Conclusion Our findings show that using sports clubs for HP interventions is effective for engaging men.Recruitment was facilitated by leveraging sports clubs’identity,addressing masculinity-related barriers,improving accessibility,and building trust.Engagement was enhanced through shared identity experiences,safe spaces,inclusive competition,and self-efficacy.However,there's limited evidence on behavior maintenance post-intervention,though involving community stakeholders seemed vital.In general,considerations should be made to avoid perpetuating traditional masculine norms,which may exclude some men and reinforce unhealthy behaviors.These findings can guide intervention development,emphasizing the need to harness men's perspectives in the process.
基金Natural Science Foundation of China(grant nos.82270991)Zhejiang Provincial Natural Science Foundation of China/Outstanding Youth Science Foundation(grant no.LR21H140002)+4 种基金Medical Health Science and Technology Major Project of Zhejiang Provincial Health Commission(grant no.WKJ-ZJ-2311)Wenzhou Science and Technology Bureau Public Welfare Social Development(Medical and Health)Science and Technology Project(grant no.ZY2021015)Opening Research Fund from Shanghai Key Laboratory of Stomatology,Shanghai Ninth People’s Hospital,College of Stomatology,Shanghai Jiao Tong University School of Medicine(grant no.2022SKLS-KFKT011)Guangxi Key Laboratory of the Rehabilitation and Reconstruction for Oral and Maxillofacial Research(grant no.GXKLRROM2106)State Key Laboratory of Oral Diseases Open Fund(grant no.SKLOD2024OF08).
文摘Periodontitis is a common oral disease characterized by progressive alveolar bone resorption and inflammation of the periodontal tissues.Dimethyl fumarate(DMF)has been used in the treatment of various immune-inflammatory diseases due to its excellent anti-inflammatory and antioxidant functions.Here,we investigated for the first time the therapeutic effect of DMF on periodontitis.In vivo studies showed that DMF significantly inhibited periodontal destruction,enhanced mitophagy,and decreased the M1/M2 macrophage ratio.In vitro studies showed that DMF inhibited macrophage polarization toward M1 macrophages and promoted polarization toward M2 macrophages,with improved mitochondrial function,inhibited oxidative stress,and increased mitophagy in RAW 264.7 cells.Furthermore,DMF increased intracellular mitochondrial Tu translation elongation factor(TUFM)levels to maintain mitochondrial homeostasis,promoted mitophagy,and modulated macrophage polarization,whereas TUFM knockdown decreased the protective effect of DMF.Finally,mechanistic studies showed that DMF increased intracellular TUFM levels by protecting TUFM from degradation via the ubiquitin-proteasomal degradation pathway.Our results demonstrate for the first time that DMF protects mitochondrial function and inhibits oxidative stress through TUFM-mediated mitophagy in macrophages,resulting in a shift in the balance of macrophage polarization,thereby attenuating periodontitis.Importantly,this study provides new insights into the prevention of periodontitis.
文摘This study examines the difference of the center of gravity (CG) velocity during sit-to-stand (STS) movement between the elderly with and without fall experience. Fifteen elderly without fall experience (age: 75.7 ± 4.8 yr), with one fall experience (age: 75.7 ± 5.0 yr), and two or more fall experiences (age: 75.7 ± 4.8 yr) participated in the measurement of 10m maximal walking speed, functional reach, one-legged standing duration with vision, maximal isometric knee extension, hip flexion, ankle extension and toe flexion muscle strengths, fall risk assessment and ADL questionnaire, and CG velocity during STS movement. No significant differences were found in muscle strength, walking and balance tests (F 0.078). The group with two or more fall experiences was significantly higher than the other groups in the fall risk assessment, and lower than the group without fall experience in ADL (F = 8.5 and 6.1, p = 0.001 and 0.005). Meanwhile, significant differences were found in the maximal and mean CG velocity during STS movement among all groups. The group without fall experience was the greatest, and the group with fall experience was less than half (F = 9.0 and 11.1, p = 0.001
文摘In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights derived from current studies.Furthermore,we emphasize the critical need for a framework regarding robust risk evaluation in patients undergoing such treatments.This framework is essential for identifying those at increased risk of HBVr,enabling healthcare providers to implement proactive measures to prevent reactivation and ensure the safe administration of BTK inhibitor therapy.
基金funded by the Major Program of Shanghai Municipality for Basic Research (08dj1400601)the National Natural Science Foundation of China (30971121)the Key Project of Science and Technology of Shanghai (09DZ1950202)
文摘Objective To determine whether smoking increases the risk for developing metabolic syndrome （MetS） in Chinese men.Methods A total of 693 men with no MetS at baseline were followed for 2.9‐5.5 years.Subjects were divided into nonsmokers,ex‐smokers,and current smokers according to baseline smoking status.Results After adjusting for age,education level,alcohol intake,fasting plasma insulin,HOMA‐IR index,and BMI at baseline and weight change,current smokers were dose‐dependently associated with increased risk for developing new MetS compared with nonsmokers.The odds ratio （OR） was 2.131 （95% CI,1.264,3.592;P0.01） for the NCEPIII definition or 3.083 （95% CI,1.807,5.295;P0.01） for the JCDCG definition of MetS.Ex‐smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition.Compared with nonsmokers,current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL‐C.Conclusion Smoking is a risk factor for developing MetS in Chinese men after adjusting for age,education level,alcohol intake,fasting plasma insulin,HOMA‐IR,BMI,and weight change.This could be due to an increased incidence of dyslipidemia.Smoking cessation for 13 years decreased the risk for developing MetS defined by the JCDCG definition.
基金supported by the Major Program of Shanghai Municipality for Basic Research (08dj1400601)Shanghai Key Laboratory of Diabetes Mellitus (08DZ2230200)supported by the Key Project of Science and Technology of Shanghai (09DZ1950202)
文摘Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.
基金Supported by a grant from The Jikei University School of Medicine and Japanese Society for Gastro-surgical Pathophysiology
文摘AIM To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy(TGRY) and distal gastrectomy with the same Rouxen-Y(DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale(PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working Party.METHODS The PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni-and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY(n = 393) or DGRY(n = 475) for stage I gastric cancer(52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy(TGRY/DGRY), interval after surgery, age, gender, surgical approach(laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life(QOL).RESULTS The patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables. CONCLUSION The results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.
文摘The purpose of this study is to prepare a nursing protocol for preventing interruptions during clinical examinations and treatments performed in the early days of hospitalization for acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the research, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 73 subjects (84.9%) considered effective for patients, in terms of prevention of interruptions during clinical examinations and treatments in the early days of hospitalization. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 84.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We consider that this nursing protocol will be useful especially for newly graduated/employed nurses as a procedure manual which can reduce their anxiety or stress caused by lack of knowledge or experiences.
基金Supported by Grants-in-Aid for Scientific Research (B), No. 15H04810 from the Japan Society for the Promotion of Science, Japanese Society of Laboratory Medicine Fund for the Promotion of Scientific Research, Foundation for Total Health Promotionsupported as a research program from the Project for Development of Innovative Research on Cancer Therapeutics (P-Direct), Ministry of Education, Culture, Sports, Science and Technology of Japan
文摘AIM: To determine the efficacy of Mac-2 binding protein (Mac-2bp) for diagnosis of chronic pancreatitis.METHODS: Fifty-nine healthy volunteers (HV), 162 patients with chronic pancreatitis (CP), and 94 patients with pancreatic ductal adenocarcinoma (PDAC) were enrolled in this study. We measured serum Mac-2bp using our developed enzyme-linked immunosorbent assay kit. Additional biochemical variables were measured using an automated analyzer (including aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, triglyceride, C-reactive protein, and amylase levels) or chemiluminescent enzyme immunoassay (carbohydrate antigen 19-9 and carcinoembryonic antigen). The ability of Mac-2bp to predict CP diagnosis accurately was assessed using receiver operating characteristic (ROC) analyses.RESULTS: Serum Mac-2bp levels were significantly increased in CP patients compared to HV (P < 0.0001) and PDAC patients (P < 0.0001). Area under the ROC curve values of Mac-2bp for the discrimination of CP from HV and PDAC were 0.727 and 0.784, respectively. Multivariate analyses demonstrated that serum Mac-2bp levels were independent determinants for CP diagnosis from HV and PDAC patients. Immunohistological staining showed that Mac-2bp was expressed faintly in the pancreas tissues of both CP and PDAC patients. Serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, and triglyceride levels were significantly higher in patients with CP or PDAC. Serum Mac-2bp levels were highly correlated with protein levels of alanine aminotransferase, γ-glutamyltransferase, and C-reactive protein, but not amylase, suggesting that the damaged liver produces Mac-2bp.CONCLUSION: Measurement of serum Mac-2bp may be a novel and useful biomarker for CP diagnosis as well as liver fibrosis in the general population.
基金Support by the Ministry of Science and Technology,Taiwan(MOST 103-2314-B-715-005-MY3)Mackay Medical College,Taiwan China(No.105B06)
文摘OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49years) women who were treated for breast cancer from January 2011 through June 2015 in a Taiwan Residents city participated in the study. Of 306 eligible study participants, interviews were completed in197(64%). Participants were asked about sociodemographic variables, disease and treatment characteristics, their desire for fertility, and their use of Western or Chinese Medicine.RESULTS: The proportions of women who planned to use Western or Chinese Medicine to help achieve pregnancy were 17.3% and 14.7%, respectively. The result of binary logistic regression showed that current employment and lack of children were factors predictive of the use of Western Medicine. Younger age and the use of Chinese Medicine before treatment were predictors of using Chinese Medicine. While the desire for fertility preservation was related to the use of Western Medicine,the desire for pregnancy was related to the use of Chinese Medicine.CONCLUSION: Various characteristics guided the women's decisions to use Western or Chinese Medicine. Health care providers should learn patients' preferences for fertility preservation and provide appropriate advice, referring them to safe providers of their desired method of fertility treatment.
文摘We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 patients, 21 patients in the newly-initiated group and 25 patients in the existing BOT group performed dose adjustment using 3-3-1 algorithm. HbA1c was significantly improved 4 weeks after the initiation from 8.5% ± 1.2% at baseline to 7.3% ± 0.7% at the final evaluation (p 0.01, vs. Baseline). The average daily insulin units increased throughout the study period from 10.1 ± 6.7 at baseline to 14.6 ± 8.9 units at the final evaluation. Weight didn’t significantly change throughout the study (p = 0.12). The incidents of hypoglycemia were 0.8/month during the insulin dose self-adjustment period and 0.4/month during the follow-up period. The 3-3-1 algorithm using insulin glargine provided a safe and simple dose adjustment and demonstrated its utility in patients who were newly introduced to insulin treatment as well as who were already on BOT.
文摘The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.
文摘BACKGROUND The prognosis of hepatocellular carcinoma(HCC)patients remains poor despite advances in treatment modalities and diagnosis.It is important to identify useful markers for the early detection of HCC in patients.Preneoplastic antigen(PNA),originally reported in a rat carcinogenesis model,is increased in the tissues and serum of HCC patients.AIM To determine the diagnostic value of PNA for discriminating HCC and to characterize PNA-positive HCC.METHODS Patients with hepatitis C virus(HCV)-related hepatic disorders were prospectively enrolled in this study,which included patients with hepatitis,with cirrhosis,and with HCC.A novel enzyme-linked immunosorbent assay was developed to measure serum PNA concentrations in patients.RESULTS Serum PNA concentrations were measured in 89 controls and 141 patients with HCV infections(50 hepatitis,44 cirrhosis,and 47 HCC).Compared with control and non-HCC patients,PNA was increased in HCC.On receiver operating characteristic curve analysis,the sensitivity of PNA was similar to the HCC markers des-γ-carboxy-prothrombin(DCP)andα-fetoprotein(AFP),but the specificity of PNA was lower.There was no correlation between PNA and AFP and a significant but weak correlation between PNA and DCP in HCC patients.Importantly,the correlations with biochemical markers were completely different for PNA,AFP,and DCP;glutamyl transpeptidase was highly correlated with PNA,but not with AFP or DCP,and was significantly higher in PNA-high patients than in PNA-low patients with HCV-related HCC.CONCLUSION PNA may have the potential to diagnose a novel type of HCC in which glutamyl transpeptidase is positively expressed but AFP or DCP is weakly or negatively expressed.
文摘BACKGROUND Ectopic adrenocorticotropic hormone(ACTH)-secreting neuroendocrine tumors are rare diseases.Patients with ACTH-secreting pancreatic neuroendocrine carcinomas have a poor prognosis.Infections and coagulopathies have been reported as the cause of death.However,detailed clinical descriptions of the morbid complications of ACTH-secreting neuroendocrine carcinomas have not been reported.CASE SUMMARY A 78-year-old Japanese woman consulted a medical center due to systemic edema and epigastric discomfort.Laboratory analysis revealed hypercortisolemia with increased ACTH secretion without diurnal variation in serum cortisol level.An enhanced computed tomography(CT)scan revealed a 3-cm tumor in the pancreatic head.The cytological material from endoscopic ultrasound-guided fine-needle aspiration was compatible with ACTHsecreting pancreatic neuroendocrine carcinoma.The Ki-67 index was 40%.She was transferred to Mie University Hospital for surgical treatment.The patient was diagnosed with urinary tract infection,cytomegalovirus hepatitis,esophageal candidiasis,pulmonary infiltrates suspicious for Pneumocystis carinii pneumonia,peripheral deep vein thrombosis,pulmonary embolism,and disseminated intravascular coagulation.The multiple organ infections and thromboses responded well to antimicrobial and anticoagulant therapy.Radioisotope studies disclosed a pancreatic tumor and a metastatic lesion in the liver,whereas somatostatin receptor scintigraphy showed negative findings,suggesting the primary and metastatic tumors were poorly differentiated.A CT scan before admission showed no metastatic liver lesion,suggesting that the pancreatic tumor was rapidly progressing.Instead of surgery,antitumor chemotherapy was indicated.The patient was transferred to another hospital to initiate chemotherapy.However,she died four months later due to the rapidly progressive tumor.CONCLUSION ACTH-secreting pancreatic neuroendocrine neoplasm is a rare disease with a very poor prognosis.The clinical course and acute complications of the tumor remain unreported.Here we report the clinical course of a rapidly progressive case of ACTH-secreting pancreatic neuroendocrine tumor that developed infectious complications due to many types of pathogens in multiple organs,widespread thromboses,pulmonary embolism,and disseminated intravascular coagulation.
基金The authors would like to thank Li LI and H.Z.Xie for the technical support.This work was financially supported by the National Natural Science Foundation of China(Nos.82002303 and 81702171)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A1515011536,2021A1515220093,2021A1515220086,2019A1515111156,and 2022A1515011815)+7 种基金the Scientific Research Foundation of Peking University Shenzhen hospital(No.KYQD2021064)the Health and Medical Research Fund(No.19180712)the Shenzhen Double Chain Project for Innovation and Development Industry supported by the Bureau of Industry and Information Technology of Shenzhen(No.201806081018272960)the Shenzhen Science and Technology Innovation Committee Projects(Nos.JCYJ20190809182213535 and JSGG20180507183242702)the program from Shanghai Municipal Health Commission(No.201740165)the National Key R&D Program of China(No.2018YFC1105100)the Hong Kong Innovation Technology Fund(Nos.ITS/287/17 and ITS/405/18)the Hong Kong Research Grant Council General Research Fund(No.17214516).
文摘The healing of critical-sized bone defects(CSD)remains a challenge in orthopedic medicine.In recent years,scaffolds with sophisticated microstructures fabricated by the emerging three-dimensional(3D)printing technology have lighted up the treatment of the CSD due to the elaborate microenvironments and support they may build.Here,we established a magnesium oxide-reinforced 3D-printed biocompos-ite scaffold to investigate the effect of magnesium-enriched 3D microenvironment on CSD repairing.The composite was prepared using a biodegradable polymer matrix,polycaprolactone(PCL),and the disper-sion phase,magnesium oxide(MgO).With the appropriate surface treatment by saline coupling agent,the MgO dispersed homogeneously in the polymer matrix,leading to enhanced mechanical performance and steady release of magnesium ion(Mg^(2+))for superior cytocompatibility,higher cell viability,advanced osteogenic differentiation,and cell mineralization capabilities in comparison with the pure PCL.The in-vivo femoral implantation and critical-sized cranial bone defect studies demonstrated the importance of the 3D magnesium microenvironment,as a scaffold that released appropriate Mg^(2+) exhibited remarkably increased bone volume,enhanced angiogenesis,and almost recovered CSD after 8-week implantation.Overall,this study suggests that the magnesium-enriched 3D scaffold is a potential candidate for the treatment of CSD in a cell-free therapeutic approach.
文摘This study aimed at examining the differences in leg strength and activities of daily living (ADL) ability among groups with various knee problems. The subjects consisted of 328 elderly females who were classified into three groups: those without knee pain or a knee disorder, those with knee pain, and those with a knee disorder. The subjects took a knee extension strength test and an ADL survey. Knee extension strength and ADL scores (total score and each domain score of the motions of locomotion, posture change, stability, and manipulation) were selected as the evaluation parameters. The knee extension strength, total ADL score and each domain score of the motions of locomotion, posture change, and stability ranged from low to high in the following order: the group with a knee disorder, the group with knee pain, and the group without pain or a knee disorder. Moreover, manipulation scores were significantly inferior in the group with a knee disorder compared with the other two groups. In conclusion, the female elderly with knee pain or a knee disorder have inferior knee extension strength and ADL with respect to the motions of locomotion, posture change and stability. In addition, with regard toknee extension strength with respect to theabove three motions, the elderly with a knee disorder have inferior scores when compared with the elderly who have only knee pain;thus, they find it difficult to perform activities involving the knee joints.
文摘Gout is a common disease caused by the deposition of monosodium urate(MSU) crystals in patients with hyperuricemia, and characterized by very painful recurrent acute attacks of arthritis. The gold standard for diagnosing gout is the identification of MSU crystals in synovial fluid by polarization light microscopy. Arthritis attacks can be treated with anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs, colchicine, oral prednisone, or intra-articular or intramuscular glucocorticoids. To prevent gout uric acid lowering therapy with for example allopurinol can be prescribed. When gout is adequately treated, the prognosis is good. Unfortunately, the management of gout patients is often insufficient. Gout is associated with dietary factors, the use of diuretics, and several genetic factors. Comorbidities as hypertension, chronic kidney disease, cardiovascular diseases, the metabolic syndrome, diabetes, obesity, hyperlipidemia, and early menopause are associated with a higher prevalence of gout. Xanthine oxidase and chronic systemic inflammation seem to play an important role in the pathophysiology of the association between gout and cardiovascular diseases. To prevent cardiovascular diseases goutpatients must be early screened for cardiovascular risk factors.
